Individual
DR. MALCOLM MATHEWS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2205 PAVILION DR, SUITE 101, KINGSPORT, TN 37660-4641
(423) 857-6466
(423) 857-6456
Mailing address
2205 PAVILION DR, SUITE 101, KINGSPORT, TN 37660-4641
(423) 857-6466
(423) 857-6456
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
0101232053
VA
207RX0202X
Medical Oncology Physician
Primary
16245
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005847966
—
VA
05
—
1952378747
—
VA
05
—
3026910
—
TN
05
—
Q011077
—
TN
Enumeration date
03/01/2006
Last updated
02/16/2017
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